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I have a hemorrhoidectomy scheduled for 4/12/12 (tomorrow). This will be my second one in 10 years. I have learned so much from reading other people's experiences on this site. I'll post a journal here to chronicle my ordeal. I hope to update it daily regardless of how much pain I'm in.

Some background:

I'm an athletic 35 year old male with 2 stage-4 thrombosed internal hemorrhoids prolapsed. My first 'ectomy was for an external roid and a 3 inch fistula. 10 years later, I still remember being curled up in a fetal position on my bathroom floor after the first few BMs. I wish back then I had this site to rely on for support and knowledge. I didn't even know what a sitz batch was the first time around. eh

My surgeon didn't give me much info, so I'm relying on this site for everything. I'm going to summarize key points I've learned to help gather my thoughts in case I forget it later.

Pre-Op Preparation:
- Fruits, veggies, oatmeal, almond milk (easier on my system than dairy or soy) 
- Metamucil
- pantie liners and gauze pads
- Aleve, Tylenol, Advil
- Cough suppressants
- Allergy pills (don't want to have a sneezing fit while stitches are still in)
- Sitz bath basin to fit over the toilet
- Preparation-H wipes (not baby wipes, which contain soaps and irritants)
- Orajel Maximum Strength (20% benzocaine with no alcohol as inactive ingredient)
- Multivitamins (I don't plan to eat a whole lot, so need supplements to help with healing and combat potential anemia from bleeding)
- Desitin Maximum Strength (40% zinc oxide)

Post-Op Ask Doc:
- Xanax/Valium
- Percocet/Vicoden
- Toradol/Ketorolac
- Ultram/Tramadol
- Gelclair
- Licocaine cream

Other notes to self: 
- Work on Lamaze exercises and try to do them during my BMs
- Make sure I don't strain, thus popping stitches. 
- If necessary, BM in sitz bath basin (probably not a good idea if you don't have a Y chromosome)
- Unless absolutely necessary, avoid opiate agonists (percocet, vicoden, tylenol-3, codeine, tramadol/ultram) to prevent constipation
- Stick to Toradol (5 days max), OTC NSAIDS, Orajel, and Gelclair
- Keep to regular pain med schedule even if pain is manageable
- Stay hydrated (I normally only drink 8-12 ounces per day--will need to multiply this by 5 or 6)
- Transform myself from carnivore to herbivore until BMs are tolerable
- Stay on Metamucil for the rest of my life to prevent recurrence. 

Slightly concerned about after-care. The colo-rectal surgery center is a 60 minute drive. Not sure how I'll tolerate the car ride for follow-up exams.

Very nervous about tomorrow and the weeks to come. :-|

Wish me luck

Ocean

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Just got home. The procedure was a closed hemorrhoidectomy. All 3 removed instead of just the 2 necrotic ones. Numbing agent wore off on the ride home. Pain is rocking my world right now. I just crawled from garage door to bedroom. still on floor typing this. I didn't think pain could get worse than 2 necrotic hemorrhoids, but it is. On top of that there's insane pressure in my rectum right now like I need to take the biggest dump of my life, but I'm not going to because I KNOW there's nothing in there.

I'll update more when I can.

this is the worst...
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finally peed 45 minutes before catheter deadline. so proud of myself right now!

tried to stay off narcotics, but impossible. took percocet 1 hour ago. still hurts a lot, but the perc makes me care less about pain. 

try to sleep now.
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after midnight now so technically day 2 now

slept for 5 minutes. hopped in tub. took another percocet. 

shivering like i got stranded naked in antarctica. why?

pain more intense than ever. tolerance to percocet already? or last of local anesthesia wearing off?
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Day 2

spent an hour in bath, then out of nowhere the urge to void hit me, and I couldn't get out in time. crapped in the tub. good thing was i didn't have to strain. it all just came out and kept coming out. i think the hot water made it a lot easier. hardly any pain as I flooded the tub with fibrous poo. bad part is right afterwards it felt like my ass was the epicenter of the Big Bang giving birth to Uranus through my anus. i couldn't get myself out of the tub, so i ended up bathing in poo water for 10 minutes. eventually i got enough nerve to get out, dry off, and fill up the bathtub in the guest room. i took 1 percocet and 1 toradol while tub filled. pain lasted about an hour--moaning in bathtub. Now I feel pretty normal. I was even able to wash dishes and play with my 2 year-old. I still can't sit down or cough or blow my nose (getting over flu), but the pain is very manageable right now.

percocet didn't constipate me like i feared, so i'll keep taking it along with my metamucil powdered drinks and fiber-one cereal (the original cardboard-tasting kind).


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Day 3 (52 hours post surgery)

everything's on the up and up. had 2 BMs today. managed to release the hostages in the toilet instead of the tub today. ;-) pain-free when coming out (very soft), but the familiar ring of fire afterwards. Only 15 minutes of intense burning after the 1st one followed by 45 minutes of more manageable throbbing. 2nd BM came 8 hours later. the intense burning lasted maybe only 5 minutes with another 45 minutes of lower-grade throbbing in the tub. a little amount of blood both times. probably less than half a teaspoon of it each time.

i'm staying on percocet every 4 hours religiously. 1 tsp of metamucil powder and a cup of fiber one cereal kept the constipation away (i started this diet days BEFORE surgery, so my body was accustomed to passing soft stools).

i'm pain-free the entire day with the exception of post-BM. still can't really sit down though. there's some slight discharge from the anus, but much less than when i had grade 4 roids. 

so far so good.
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Day 4

Today I took a step back, but I learned a lot from it. BMs are still regular and very soft and volumous. The first BM went as expected--primary (paralyzing) pain lasting about 10-15 minutes followed by secondary pain that had me in the tub for over 2 hours. I actually took more percocet this time (2 instead of 1), but that didn't help at all.  I couldn't understand why this secondary pain lasted so long this time when it looked like everything was going so well. Then 10 minutes after I took the Toradol, my pain disappeared entirely. I realized there must be an inflammation component to the post BM burning that does not get addressed by the narcotic pain meds. I can't take Toradol more than 1 every 8 hours, and today's first BM caught me at the tail end of the Toradol's cycle whereas previous days my BM took place while Toradol was in full swing in my body.

I actually had 3 BMs today. The 2nd and 3rd went much better. I took 400mg Advil 10 minutes before each BM (I couldn't take Toradol again due to inappropriate timing, so Advil was my alternate NSAID). The primary pain lasted a little over 5 minutes, and secondary pain lasted about 15 minutes each time. The percocet was already in my system, and I didn't take any extra for the BMs. While the pain duration for the 2nd and 3rd BMs were much less than the first, the intensity did not seem to be affected by the NSAID.

My biggest problem today (and every day) is with urination. It's so HARD to pee. I sometimes try for 2-3 HOURS to get it out. Actually my 3rd BM happened because I strained too hard trying to pee. Pee never came out, but poo did! So frustrating!

I'm getting some muscle relaxers tonight to help with that issue as well as the occasional anal/rectal spasms.

Hoping to make bigger improvements tomorrow. 

Ocean
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Day 5

Wow, is it day 5 already? the progress is slow, but I think I'm still making progress. It's discouraging how much pain there still is after BMs. I had 3 BMs again today... too many for my liking. I wish percocet would constipate me more! I added flexeril to my meds, so we'll see if that slows things down a bit down there. 

I used the sitz pan for my 2nd BM today. felt soooo good! problem was the pan filled up so quickly, so I had to stop. I probably could have pooped more if the pan could have been 3 inches deeper. The inability to finish there caused me to have another BM 2 hours later, which really sucked.

So no more using sitz bath pan for poops. 

still having hard time peeing, but flexeril helps a little. 

I was concerned about the synergistic effect of muscle relaxant and narcotics, but adding flexeril didn't kill me :)  I just got a little more sleepy than taking percocet alone. Flexeril also took away my percocet dreams, which helped me sleep a lot better. 

swelling, protrusion, skin tags, and discharge are all still present, but not too bad.

Ocean
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Day 6

Only 1 day away from that magical 1 week mark! 

My wife complained about how hard my recovery has been on her. She has to do all the housework now. She even called me selfish/inconsiderate when I texted her to go to the store to get some Gas-X for me on her way home from the park. She was tired and having a bad day, and just wanted to come home. 8-| I guess it's hard to understand what this recovery is like unless you go through it yourself. What I wouldn't give to have a regular bad/stressful day without the pain in my ass to worry about! That's why reading all the stories here and posting on this forum has been so therapeutic for me (and probably for many others too). We get to share our pain with others who really understand us.

Today was another step in the right direction, although in a lot of ways Day 3 still seemed like the easiest for me so far.

Had 2 poos today. Pain after BM was much better than all other days. By better, I mean the phase 1 pain didn't last as long. Only 4-5 minutes each time. Then phase 2 pain was about 10 minutes each time. I still ended up spending an hour in the tub each time because it felt so good.

The thing that made today harder than day 3 was the constant pressure/throbbing in my anus. The pain was manageable, but it was enough to keep me in bed/tub all day. No chores for me today.

Still having trouble urinating. One episode lasted 3 hours. I strain more trying to get urine out than poo out, which probably contributed toward the low-grade anal throbbing. I was hoping the flexeril would help relax my muscles enough to pee easier, but that doesn't seem to work. I may have to get off the percocets as I have a feeling that's what's causing my urinary problems. Ironic how the whole time I was worried about bowel constipation, but ended up getting bladder constipation lol.


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Day 7

1 Week!!! It finally looks like I'm making good progress. I still had 3 BMs today even though I cut down on fiber to half of before. No luck :(   I actually ate very little yesterday (400 calories all day), yet my poos look like I competed in an eating contest ... and won.

The pain after each BM is much better now. Phase 1 lasts only 1-2 minutes, and phase 2 lasts about 10 minutes, then I end up dozing off in the tub.

I also find it helpful to distract myself rather than concentrate on the pain. I'll play with my mobile phone or browse the internet. It's really hard to do during the phase 1 pain, but it really helps me.

I still can't walk very far. It's just too much pressure on my rectum/anus. So I'm still spending the majority of my days in bed (or bathtub). Getting cabin fever :)


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Day 8

Now that the 1 week mark has passed, I saw a leap forward in recovery today. Phase 1 pain after BM lasts less than a minute, although I still need to submerge myself in a bath. Phase 2 pain is anywhere from 5-15 minutes. I was able to do a lot more chores around the house today--packed for about 3 hours (we're moving in 3 days). I got on Flomax, and OMG that eliminated the urinary retention issue. I feel so liberated! Why this wasn't prescribed to me from day 1 is a mystery.

Then things took a turn for the worse. I got a cough, and I couldn't get rid of it for about 5 hours in the evening. That was pretty traumatic for down there. Then I got diarrhea. Not from too much fiber. It was the kind that gives me stomach cramps and nothing stays in the colon very long before having to come out right away. Maybe some type of stomach virus. I Ended up pooping about 10 times last night. Although pain after BM is significantly shorter now, so many BMs was excruciating. That was definitely my worst night so far.


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Day 9

another leap forward in recovery. had 2 poos today. waited for phase 1 pain but it never came. still burned a lot but pain didn't paralyse me today. Was able to go to work for 4 hours. i have an office job so i ended up standing/kneeling the whole time.

still very swollen down there. feels like 3 huge skin tags hanging out. a piece of string is also hanging out. i assume that's part of the stitches. discharge smells worse than ever.
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Day 10

Another good day. It was mostly pain-free even without pain meds (not even OTC meds) for most of the day. I did need some advil after my morning BM. I'm still a long ways away from walking without pain or sitting normally without pain. I walked a mile this afternoon. Took about an hour. Then I had to take 3 advils afterwards. 

I poop a lot less now that I stopped percocet. Weird. 

The discharge is the worst. It smells so bad!!! I normally don't mind foul smells from my own body. My farts, poops, and dirty feet don't bother me, but this discharge activates my gag reflexes. I can't wait for that to be over with.


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The smell is rather unpleasant. I had a black string hanging out at around the same time as you so I decided to pull it and it turned out to be the banding and attached a dead hemorrhoid (gross) I think that is also what the smell is. Hold in there, week 3 - 4 gets easier.

I've also got what looks like 2 bits of skin that look like an external hemorrhoid still showing - One bit looks like its trying to heal to the other bit. I was worried and ended up going to the hospital. The surgeon advised that it is swelling and could possibly take 2 months to heal. It is definitely going down day by day but literally only a millimetre a day and by the time you have had your bowel movement it swells a bit again.

I'm hoping it eventually heals up and is just swelling ;)
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Thedynamo-- thanks for sharing your experiences! How far along are you? Are you at the 4th week? The swelling has me concerned too. I would have thought those were my hemorrhoids that didn't get completely cut out, but from everything I've read on here, it seems pretty normal. So I won't bother my doc about them now.

The odor smells the same as my discharge when I had hemorrhoid flare ups, but it's just a lot stronger now. For the last 4-5 years, I would have uncontrollable discharge after every BM, but it only lasted anywhere from a couple of minutes to an hour. I wouldn't notice the smell unless I put my nose to my underwear. Now the discharge keeps coming out 24/7, so the sheer volume of it makes the smell a lot more potent. I can smell it when I'm fully clothed, just walking around. I need to wash my butt every 4-5 hours to keep it in check. 

Day 11

Today has been another day of improvement. Although I still can't walk normally or sit down, I'm encouraged by the progress. Lately each day has been better than the last. The pain after my morning BM was very mild. I didn't really need a bath, but since the tub was full, I decided to hop in anyway. I had another BM at 10pm tonight, and managed with only a shower afterward. It was my first BM without a bath afterward. Very liberating!

I still need my NSAIDs, but no narcotics during the day. I was pain-free for the most part today even after BMs. There's just an uncomfortable throbbing at the anus, kind of like a moderate hemorrhoid flare-up feeling. I take a couple of Vicodins at night to help me sleep. The pain is not bad, but it's enough to prevent me from staying in deep sleep for a long period of time, so I save the narcotics for bed time.

We're moving into a new house tomorrow, so I've been busy packing. I probably overworked myself a little bit, but it feels good to not be in bed/bath all day. Thankfully a moving company will move everything for us.
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